Archive for the ‘arthritis’ Category

Arthritis Among Veterans — United States, 2011–2013

November 12, 2014 Comments off

Arthritis Among Veterans — United States, 2011–2013
Source: Morbidity and Mortality Weekly Report (CDC)

Arthritis is among the most common chronic conditions among veterans and is more prevalent among veterans than nonveterans (1,2). Contemporary population-based estimates of arthritis prevalence among veterans are needed because previous population-based studies predate the Persian Gulf War (1), were small (2), or studied men only (2) despite the fact that women comprise an increasing proportion of military personnel and typically have a higher prevalence of arthritis than men (1,3). To address this knowledge gap, CDC analyzed combined 2011, 2012, and 2013 Behavioral Risk Factor Surveillance System (BRFSS) data among all adults aged ≥18 years, by veteran status, to estimate the total and sex-specific prevalence of doctor-diagnosed arthritis overall and by sociodemographic categories, and the state-specific prevalence (overall and sex-specific) of doctor-diagnosed arthritis. This report summarizes the results of these analyses, which found that one in four veterans reported that they had arthritis (25.6%) and that prevalence was higher among veterans than nonveterans across most sociodemographic categories, including sex (prevalence among male and female veterans was 25.0% and 31.3%, respectively). State-specific, age-standardized arthritis prevalence among veterans ranged from 18.8% in Hawaii to 32.7% in West Virginia. Veterans comprise a large and important target group for reducing the growing burden of arthritis. Those interested in veterans’ health can help to improve the quality of life of veterans by ensuring that they have access to affordable, evidence-based, physical activity and self-management education classes that reduce the adverse effects of arthritis (e.g., pain and depression) and its common comorbidities (e.g., heart disease and diabetes).

Acupuncture: What You Need To Know

August 18, 2014 Comments off

Acupuncture: What You Need To Know
Source: National Center for Complementary and Alternative Medicine

What’s the Bottom Line?

How much do we know about acupuncture?
There have been extensive studies conducted on acupuncture, especially for back and neck pain, osteoarthritis/knee pain, and headache. However, researchers are only beginning to understand whether acupuncture can be helpful for various health conditions.

What do we know about the effectiveness of acupuncture?
Research suggests that acupuncture can help manage certain pain conditions, but evidence about its value for other health issues is uncertain.

What do we know about the safety of acupuncture?
Acupuncture is generally considered safe when performed by an experienced, well-trained practitioner using sterile needles. Improperly performed acupuncture can cause serious side effects.

NCCAM Clinical Digest: Dietary Supplements for Osteoarthritis

June 2, 2014 Comments off

NCCAM Clinical Digest: Dietary Supplements for Osteoarthritis
Source: National Center for Complementary and Alternative Medicine

Osteoarthritis, which affects an estimated 27 million Americans, is a leading cause of disability in older adults. Because the general population is aging and obesity, a major risk factor, is increasing in prevalence, the occurrence of osteoarthritis is on the rise. Clinical practice guidelines issued by the American College of Rheumatology recommend aerobic exercise and/or strength training, weight loss (if overweight), and a number of pharmacological and non-pharmacological modalities for treating OA of the knee, hip, or hand.

Many people with OA report trying various dietary supplements in an effort to relieve pain and improve function. However, there is no convincing evidence that any dietary supplement helps with OA symptoms or the underlying course of the disease. This issue of the digest summarizes current scientific evidence about several dietary supplements most often used by people with OA, including glucosamine and chondroitin sulfate, Dimethyl Sulfoxide (DMSO) and Methylsulfonylmethane (MSM), S-Adenosyl-L-methionine (SAMe), and herbal remedies.

Falls and Fall Injuries Among Adults with Arthritis — United States, 2012

May 20, 2014 Comments off

Falls and Fall Injuries Among Adults with Arthritis — United States, 2012
Source: Morbidity and Mortality Weekly Report (CDC)

Falls are the leading cause of injury-related morbidity and mortality among older adults, with more than one in three older adults falling each year,* resulting in direct medical costs of nearly $30 billion (1). Some of the major consequences of falls among older adults are hip fractures, brain injuries, decline in functional abilities, and reductions in social and physical activities (2). Although the burden of falls among older adults is well-documented (1,2), research suggests that falls and fall injuries are also common among middle-aged adults (3). One risk factor for falling is poor neuromuscular function (i.e., gait speed and balance), which is common among persons with arthritis (2). In the United States, the prevalence of arthritis is highest among middle-aged adults (aged 45–64 years) (30.2%) and older adults (aged ≥65 years) (49.7%), and these populations account for 52% of U.S. adults (4). Moreover, arthritis is the most common cause of disability (5). To examine the prevalence of falls among middle-aged and older adults with arthritis in different states/territories, CDC analyzed data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) to assess the state-specific prevalence of having fallen and having experienced a fall injury in the past 12 months among adults aged ≥45 years with and without doctor-diagnosed arthritis. This report summarizes the results of that analysis, which found that for all 50 states and the District of Columbia (DC), the prevalence of any fall (one or more), two or more falls, and fall injuries in the past 12 months was significantly higher among adults with arthritis compared with those without arthritis. The prevalence of falls and fall injuries is high among adults with arthritis but can be addressed through greater dissemination of arthritis management and fall prevention programs in clinical and community practice.

Clinical Digest — Spotlight on a Modality: Omega-3 Fatty Acids

September 9, 2013 Comments off

Clinical Digest — Spotlight on a Modality: Omega-3 Fatty Acids
Source: National Center for Complementary and Alternative Medicine

Omega-3 fatty acids have been in the news lately, after a new study raises concern about the association of omega-3s and an increased risk of prostate cancer. Omega-3s are a popular supplement used by many Americans. In fact, according to the 2007 National Health Interview Survey, which included a comprehensive survey on the use of complementary health practices by Americans, fish oil/omega-3/DHA supplements are the natural product (excluding vitamins and minerals) most commonly taken by adults, and the second most commonly taken by children.

Moderate evidence has emerged about the health benefits of consuming seafood, but the health benefits of omega-3s in supplement form are less clear. For example, the findings of individual studies on omega-3 supplements and heart disease have been inconsistent, and in 2012, two combined analyses of the results of these studies did not find convincing evidence that omega-3s protect against heart disease.

There is some evidence that omega-3s are modestly helpful in relieving symptoms in rheumatoid arthritis. Omega-3s may also be helpful for age-related macular degeneration (AMD; an eye disease that can cause loss of vision in older people). For most other conditions for which omega-3s are being studied, definitive conclusions cannot yet be reached. This issue of the digest provides information on what the science says about omega-3’s effectiveness and safety for several conditions for which there is the most evidence, including heart disease, rheumatoid arthritis, infant development, and diseases of the eye and brain.

State-Specific Prevalence of Walking Among Adults with Arthritis — United States, 2011

May 7, 2013 Comments off

State-Specific Prevalence of Walking Among Adults with Arthritis — United States, 2011

Source: Morbidity and Mortality Weekly Report (CDC)

Walking contributes to total physical activity and is an appropriate activity to increase overall physical activity levels among adults with arthritis. Walking also is the most preferred exercise among arthritis patients (1,2) and has been shown to improve arthritis symptoms, physical function, gait speed, and quality of life (3–5). To estimate the distribution of average weekly minutes of walking among adults with arthritis by state and map the prevalence of low amounts of walking (<90 minutes per week) among adults with arthritis, CDC analyzed data from the 2011 Behavioral Risk Factor Surveillance System (BRFSS). This report describes the results of that analysis, which indicated that among adults with arthritis in the 50 states and the District of Columbia (DC), the median prevalence of walking was 53% (range: 44.3%–66.2%) for 0 minutes per week, 13.1% (range: 9.3%–16.2%) for 1–89 minutes per week, 5.3% (range: 3.2%–6.8%) for 90–119 minutes per week, 5.6% (range: 2.6%–8.3%) for 120–149 minutes per week, and 23.2% (range: 16.0%–30.6%) for ≥150 minutes per week. A state median of 66% of adults with arthritis walked <90 minutes per week, ranging from a low of 58.0% in California to a high of 76.2% in Tennessee. The large number of persons with arthritis who are not getting the full benefit of regular walking might benefit from community interventions aimed at increasing access to walking as well as specific programs that offer social support.

Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis

March 22, 2013 Comments off

Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis
Source: New England Journal of Medicine

Symptomatic, radiographically confirmed osteoarthritis of the knee affects more than 9 million people in the United States.1 Meniscal tears are also highly prevalent, with imaging evidence of a meniscal tear observed in 35% of persons older than 50 years of age; two thirds of these tears are asymptomatic.2 Meniscal damage is especially prevalent among persons with osteoarthritis3,4 and is frequently treated surgically with arthroscopic partial meniscectomy. This procedure, in which the surgeon trims the torn meniscus back to a stable rim, is performed for a range of indications in more than 465,000 persons annually in the United States.5

The high prevalence of meniscal tears in patients with osteoarthritis of the knee and the observation that these lesions are often asymptomatic challenge the ability of clinicians to determine whether symptoms are caused by the tear, osteoarthritis, or both. Clinicians who suspect that the tear is symptomatic may refer the patient to a surgeon for arthroscopic partial meniscectomy. The role of arthroscopic surgery in patients with osteoarthritis has been studied in two randomized, controlled trials over the past decade. One trial6 compared arthroscopic débridement and lavage with a sham surgical procedure, and the other7 compared arthroscopic débridement with a nonoperative regimen. Neither trial showed a statistically significant or clinically important difference between the arthroscopic and nonoperative groups with respect to functional improvement or pain relief over a period of 24 months.6,7

These landmark trials established that arthroscopic treatment was not superior to the other interventions in the treatment of knee osteoarthritis, but they did not focus on management of a symptomatic meniscal tear, which is a frequent indication for knee arthroscopy in patients with osteoarthritis of the knee. The efficacy of arthroscopic partial meniscectomy in symptomatic patients with a meniscal tear and osteoarthritis has been evaluated, to our knowledge, in only one randomized, controlled trial, which was a single-center study involving 90 patients.8,9 This study did not show a significant difference in pain relief or functional status between arthroscopic partial meniscectomy plus a physical-therapy regimen and physical therapy alone. Given the frequency and cost of arthroscopic partial meniscectomy and the paucity of data, we designed the Meniscal Tear in Osteoarthritis Research (METEOR) trial to assess the efficacy of arthroscopic partial meniscectomy as compared with a standardized physical-therapy regimen for symptomatic patients with a meniscal tear and concomitant mild-to-moderate osteoarthritis.